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What is Alcohol Withdrawal Syndrome?

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Withdrawal is a part of all types of addiction, whether it involves drugs, alcohol, or nicotine. Even those suffering from behavioral addictions not involving drugs or alcohol like gambling, eating, or sex can suffer from the symptoms of withdrawal.

Since alcohol is the most commonly abused substance, it’s also the most common cause of withdrawal. Alcohol withdrawal syndrome is one of the most dangerous types of withdrawal and can be life-threatening if not treated promptly.

Alcohol withdrawal occurs when an individual has been drinking regularly for an extended period of time, weeks, months, or years, and suddenly stops or reduces their alcohol consumption. The onset of symptoms generally begins between two to eight hours after the last drink, and reaches their peak between 24 – 72 hours, but they can linger for weeks.

A person in withdrawal will feel terrible, and experience most if not all of the following symptoms:

  • Shakes and tremors
  • Nausea and dry heaving
  • Sweating
  • Headaches
  • Extreme anxiety
  • Rapid heartbeat
  • Depression
  • Nightmares
  • Irritability and mood swings
  • Fatigue and listlessness
  • Mild hallucinations
  • Diarrhea

If the alcohol withdrawal is severe, the sufferer might experience a condition known as delirium tremens, commonly called DT’s, which is characterized by extreme confusion, hallucinations, fever, and serious seizures, possibly resulting in death. Because the symptoms of alcohol withdrawal syndrome can worsen rapidly, it’s important to seek medical treatment even if the symptoms are only mild.

The Causes of Alcohol Withdrawal Syndrome

Drinking alcohol affects chemicals in the brain that facilitate communication between one part of the brain to another. These chemicals are known as neurotransmitters, and drinking enhances the function of a particular neurotransmitter that helps induce relaxation and feelings of euphoria.

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For moderate drinkers, this effect is temporary and only requires a small amount of alcohol. But regular drinking causes neurotransmitters to gradually suppress their activity, and greater amounts of alcohol are needed to produce the same results. This is known as building tolerance.

Chronic abuse also suppresses the functioning of another neurotransmitter called glutamate, which produces feelings of excitement. In an effort to counteract the effects of the alcohol, the glutamates start producing at much higher levels.

When a heavy drinker suddenly stops drinking, or even just cuts consumption considerably, the neurotransmitters that were being suppressed begin to rebound, and the brain enters into an overactive state called hyperexcitability. This is what produces the symptoms of alcohol withdrawal syndrome. It’s the extreme opposite of the effects of alcohol.

Treating Alcohol Withdrawal Syndrome

The treatment of alcohol withdrawal syndrome involves three goals:

  • To reduce the immediate symptoms
  • To prevent serious complications
  • To provide therapy to address the abuse

Those experiencing mild to moderate withdrawal symptoms can often be treated on an outpatient basis, with sedatives to alleviate the worst of the symptoms, a physical examination and tests to reveal any other health problems related to drinking, and counseling to address the longer-term issue of alcohol abuse. If someone is experiencing withdrawal, they probably have a substance abuse problem.

If someone is experiencing severe withdrawal, they need to be treated on an inpatient basis so they can be closely monitored for signs of DTs and seizures. They will also be examined and tested for organ damage and other illnesses, and more intensive rehabilitation therapy is often necessary.

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If you know someone who suffers from alcohol abuse, it’s important they seek professional guidance before the condition gets worse. Destination Hope is available 24 hours a day for a confidential consultation. Contact us today.


  1. David C. Dugdale, III, MD, Alcohol Withdrawal, NIH Medline Plus, 1/1/2013,
  2. No author given, Alcohol Withdrawal, – Harvard Health Publications, 2015,

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